Home Care

Community Services – Home Care

Where are we now

Sutton Council is committed to ensuring the provision of high-quality, personalised home care services that enable individuals to maintain independence and well-being within their own homes for as long as possible. Our strategic approach to home care is underpinned by a Flexible Framework, implemented in September 2023, designed to foster a sustainable, responsive, and quality-driven market.

Our Vision: To provide an innovative and person-centred home care market in Sutton that delivers timely, effective, and flexible support, empowering residents to live fulfilling lives within their communities.

Our Strategic Priorities: Localised Provision: Through a geographical patch-based model (13 patches), we aim to enhance local recruitment opportunities for providers, thereby reducing travel times and fostering stronger community connections between care workers and service users.

Quality Assurance and Oversight: The Framework mandates electronic call monitoring systems for all providers, enabling robust oversight by the Council to guarantee consistent performance and high standards of care and support. The reduced number of commissioned providers facilitates closer collaboration and monitoring.

Inclusive Care Provision: We have expanded home care services to specifically address the needs of individuals with a Learning Disability and those with mental health conditions, ensuring a more comprehensive and equitable service offer.

Responsiveness to Demand: The Flexible Framework allows for re-opening to onboard additional providers, ensuring we can effectively respond to increasing demand for home care services within the borough.

Our Commitment: Sutton Council is dedicated to working collaboratively with our commissioned providers to continuously improve and adapt our home care services. We aim to ensure that all residents requiring care and support receive person-centred, high-quality interventions that promote their independence and enhance their quality of life. We will continue to monitor market trends and service effectiveness to ensure our Framework remains robust and responsive to the evolving needs of our community.

Current Market Landscape (July 2025 Data):

Quality: The overall quality of home care providers in Sutton is strong. Of 50 commissioned providers, 92% are rated ‘good’ by CQC, with 2% rated ‘outstanding’. Only 6% of providers’ most local registered branches are awaiting their first CQC inspection.

Provider Registration: 21 of our commissioned providers are registered within Sutton, with an additional 17 registered in bordering authorities (Merton, Croydon, Kingston Upon Thames, Surrey), demonstrating a strong regional presence. The remaining 12 providers are registered elsewhere.

Service Utilisation by Ward (June 2025): Home care hours are distributed across all wards, with Wallington South receiving the largest proportion (8.6% or 1,118 weekly hours) and Sutton West and East Cheam receiving the lowest (2.3% or 293 hours).

Service Utilisation by Age and Gender (June 2025): Weekly support hours generally increase with age, with the age 85-95 cohort receiving the highest number of hours (32.2%). Females receive a significantly higher proportion of care hours (63.2%) compared to males (36.2%), particularly for those over 50.

Primary Support Reasons (June 2025): The majority of home care expenditure (66.6%) is allocated to individuals with physical support needs. Other significant support reasons include memory and cognition (7.8%), mental health (7%), learning disability (5.5%), and sensory support (5.2%).

Diagram 1 : CQC Ratings of Home Care Providers

Data Source: CQC (July 2025)

The overall quality in the home care market is good.  The graph above shows that of the 50 commissioned home care providers, 46 (92%) are rated as ‘good’ by CQC, with 1 provider (2%) rated as ‘outstanding’ and 3 providers (6%) whose most local registered branch has not yet been inspected by CQC.

Table 1: Local Authority Area of Provider Registration

Data Source: CQC (July 2025)

The table above shows the Local Authority area in which the 50 Commissioned Service Providers are registered. 21 Providers are registered in Sutton and 17 in the bordering authorities as follows: 4 registered in Merton, 9 in Croydon, 2 in Kingston Upon Thames and 2 in Surrey. The remaining 12 providers are registered elsewhere.

Table 2: Care Hours Commissioned and number of people supported by Ward

Data Source: Mosaic (June 2025)

The table above shows the number and percentage of care hours commissioned in each ward within Sutton, during a period of 1 week in June 2025. The ward of Wallington South represents the largest proportion of home care delivery at 9.3% , followed by Sutton North (7.4%). The wards with the lowest proportion of care hours delivered were Carshalton South & Clockhouse at 3.2%  and Hackbridge 2%.  Care being provided outside of the Borough amounted to only 1.6% of the total Home Care hours.

Diagram 2: Number of Hours of Care Delivered Per Week (By Age and Gender)

Data Source: Mosaic (June 2025)

The graph above show that the weekly support hours commissioned, increase steadily as age increases, apart from the oldest group, primarily due to the smaller size of the cohort. (Please see graph further below for the size of each age group cohort).  The lowest number of weekly care hours is commissioned for the 18 to 25 group, who receive 249 hours of care per week (1.9%) followed by the oldest group of 95 + year olds receiving 918 weekly hours (7.1%).  The Cohort aged 85-95 receives the highest number of weekly commissioned support hours (4160, 32.2%), followed by the 75-80 group, receiving 3382 (26.1%) weekly hours and the 65-74 group, receiving 1945 (15%) weekly hours.  Individuals aged 26 to 49, receive a total of 928 hours of care (7.2%) a week, with 50 to 64 year olds receiving 1353 hours (10.5%).  The total number of care hours delivered to Service Users identifying as female is 8184  (63.2%) and 4685 hours (36.2%) to Service Users identifying as male.  The graph also shows that over the age of 50 a higher number of care hours are delivered to residents identifying as  female, whereas under the age of 50 the majority is male.

Diagram 3: Number of Packages of Care by Age Group

Data Source: Mosaic (June 2025)

The graph above shows how many Packages of Care (POCs) are commissioned in each of the seven age bands.  The number of POCs roughly corresponds to the number of individuals however not exactly as a small number of individuals in exceptional circumstances receive more than one package of care.  Older People aged 65+ account for the majority of those receiving commissioned home care in Sutton. Of this majority group, 135 POCs (15% of the total) are for individuals aged 64 to 74, 238 (26.4%) for those whose age is 75 to 84, 290 (32.5%) 85 to 94, and 57 (6.3%) 95+. 

Of the POCs for adults under the age of 65, only 16 POCs (1.8% of the total) are commissioned for individuals aged 18 to 25, 62 POCs (6.9%) for those aged 26 to 49 and  103 POCs (11.4%) for individuals within the 50 to 64 age group.

 

As part of the adult social care assessment process, individuals who are identified as having an eligible need for ongoing care and support, have their ‘Primary Support Reason’ identified and recorded. Individuals may have a number of identified needs, however a primary reason for support will always be identified.

Diagram 4: Gross Cost of Care by Primary Support Reason

Data Source: Mosaic (June 2025)

The pie chart above shows how the gross cost of commissioned homecare services is spread according to primary support reasons, at a specific moment in time in June 2025. The majority of homecare spend (66.6%) is for those adults with physical support recorded as their primary support reason. Memory & cognition represents the second largest spend area (7.8%), followed by mental health (7%), learning disability (5.5%), sensory support (5.2%), and old age comorbidities 2.8%.  “Other” reasons (7.2%) includes support to carers, social isolation, substance misuse and families in acute stress.

Our Home Care Market – Adults Aged 18 +

June 2025  records show Sutton Council commissions 50 Care Quality Commission (CQC) regulated home care providers delivering long term care and support just over 900 adults aged 18+ living in their own homes. 

PHYSICAL SUPPORT NEED AS PRIMARY CARE NEED

Records of a sample date in June 2025 show that 569 people of the total 901 individuals in receipt of Homecare Services, had physical support recorded as being their primary support reason (66.6% of total gross cost – see above diagram 4)

Diagram 5: Number of Care Hours delivered to SUs having Physical Support as primary need (By Age Group )

Data Source: Mosaic (June 2025)

A total of 8,610 hours of home care per week (68 % of the total) are provided to the 569 individuals for whom physical support is recorded as being their primary support reason. Of this total of hours per week, 19 hours of care per week are delivered to those aged 18 to 25 (0.2%), 361 hours to those aged 26 to 49 (4.2%), 794 hours to those aged 50 to 64 (9.2%), 1,400 hours to those aged 65 to 74 (16.3%), 2,211 hours to those aged 75 to 84 (25.7%), 3,084 hours to those aged 85 to 94 (35.8%), and 741 hours to those individuals aged 95+ (8.6%). 

Diagram 6: Gender of SUs having Physical Support as primary need

Data Source: Mosaic (June 2025)

Of those service users receiving home care whose primary support reason is recorded as physical support, 64.7% identify as female and 34.3% identify as male.  The gender of a very small number of people (1%) is unknown.

MEMORY AND COGNITIVE SUPPORT NEED AS PRIMARY CARE NEED

Records of the same sample date in June 2025 show 63 individuals received homecare support for whom Memory & cognition was recorded as being their primary support reason, representing the second largest spend area (7.8% – see diagram 4 above ).

Diagram 7: Weekly Home Care Hours delivered to SUs having Memory and Cognition as primary support reason (By Age Group)

Data Source: Mosaic (June 2025)

A total of 1,005 hours of home care per week (8% of the total commissioned hours) are provided to the 63 individuals for whom memory & cognition is recorded as being their primary support reason. Of this total of hours per week, 12 hours  (1.1%) of care per week are delivered to those aged 50 to 64 , 114 hours (11.3%) to those aged 65 to 74, 392 hours to those aged 75 to 84 (39%), 409 hours to those aged 85 to 94 (40.7%) and 79 hours to those individuals aged 95+ (7.8%).

Diagram 8: Gender of SUs having Memory and Cognition as primary support reason

Data Source: Mosaic (June 2025)

Of those service users receiving home care whose primary support reason is recorded as memory and cognition, 74.2%  identify as female and 25.8% identify as male.

MENTAL HEALTH SUPPORT AS PRIMARY CARE NEED

Diagram 9: Weekly Care Hours delivered to SUs having Mental Health as primary support reason (By Age Group)

Data Source: Mosaic (June 2025)

The diagram above shows a breakdown of the total 906 weekly hours (7% of gross spending) provided to the 91 individuals for whom mental health is recorded as being their primary support reason. Of this total of hours per week,  31 hours (3.4%) are delivered to those aged 18 to 25, 174 hours (19.2%) to those aged 26 to 49, 218 hours (24.1%) to those aged 50 to 64, 296 hours (32.7%) to those aged 65 to 74, 142 hours (18.9%) to those aged 75 to 84, 45 hours (15.6%) to those aged 85- to 94, no hours to those individuals aged 95+.

Diagram 10: Gender of SUs having Mental Health as primary support reason

Data Source: Mosaic (June 2025)

Of those service users whose primary support reason is recorded as mental health, 36% identify as male and 64% identify as female.

LEARNING DISABILITY AS PRIMARY CARE NEED

Diagram 11 : Weekly Care Hours delivered to SUs having Learning Disability as primary support reason          (By Age)

 

Data Source: Mosaic (June 2025)

The diagram above shows a breakdown of the total 712 weekly hours (5.5% of gross spending) provided to the 46 individuals for whom learning disability is recorded as being their primary support reason. Of this total of hours per week, 103 hours (14.5%) of care per week are delivered to those aged 18 to 25, 373 hours (52.4%) to those aged 26 to 49, 186 hours (26.1%) to those aged 50 to 64, 26 hours (3.7%) to those aged 65 to 74 and 24 hours (12.4%) to those aged 75 to 84.

Diagram 12 : Gender of SUs having Learning Disability as primary support reason

Data Source: Mosaic (June 2025)

Of those service users whose primary support reason is recorded as learning disability, 62%  identify as male and 38% identify as female.

SENSORY IMPAIRMENT AS PRIMARY CARE NEED

Diagram 13: Weekly Care Hours delivered to SUs having Sensory Impairment as primary support reason      (By Age)

Data Source: Mosaic (June 2025)

The diagram above shows a breakdown of the total 395 weekly hours (3.2% of gross spending) provided to the 26 individuals for whom sensory impairment is recorded as being their primary support reason. Of this total of hours per week, 41 hours (10.4%) of care are delivered to those aged 50 to 64, 32 hours (8%) to those aged 65 to 74, 100 hours (25.4%) to those aged 75 to 84, 163 hours (41.3%) to those aged 85 to 94, and 59 hours (14.9%) to those individuals aged 95+.

Diagram 14: Gender of SUs having Sensory Support as primary support reason

Data Source: Mosaic (June 2025)

Of those service users whose primary support reason is recorded as sensory impairment, 87% identify as female and 33% identify as male.

Diagram 15: Types of sensory support needs

Data Source: Mosaic (June 2025)

Of the service users receiving domiciliary care, identified as having sensory impairment as their primary support reason, 54% require support for a visual impairment, 35% require support for a hearing impairment, and 11% require support for dual impairment.      

Where we want to be – Our Vision

Over the 6-year lifespan of the Flexible Framework (2023-2029), Sutton Council envisions a significantly evolved home care landscape. Our objective is to move towards a reformed model of care that is not only ethical and strengths-based but also deeply responsive to the individual needs and aspirations of adults. This will empower them to live independently and actively within their homes and communities.

Our commitment to a sustainable and high-quality home care provision is underpinned by the following key aspirations:

  • Enhanced Service User Choice and Control: We aim to empower individuals to have greater autonomy in shaping their care, ensuring services truly reflect their preferences and goals.
  • Flexible, Integrated, and Value-Driven Services: We will foster services that are seamless, adaptable to changing needs, and deliver optimal value for money, ensuring resources are utilised efficiently to achieve meaningful outcomes.
  • Outcome-Focused Quality Care at Affordable Costs: Our emphasis will be on commissioning services that deliver demonstrable positive outcomes for individuals, with a strong focus on enabling independence and maintaining high standards of care without undue financial burden.
  • Promotion of Independence, Recovery, Rehabilitation, and Reablement: Services will be designed to actively support individuals in regaining or developing skills, facilitating recovery from illness or injury, and promoting long-term independence.
  • Proactive Health Promotion and Illness Prevention: We seek to integrate preventative measures and well-being initiatives into home care, reducing the reliance on reactive interventions and fostering healthier lives.
  • Empowering Independence Beyond Social Care: Where appropriate and feasible, we will support individuals in transitioning from formal social care services by equipping them with the tools and confidence to manage their own independence.

Leveraging Technology for Independent Living: We will actively explore and implement tech-enabled care options, increasing understanding and adoption to further enhance independent living capabilities for residents.

Challenges and Market Influencers

Key Challenges:

  • Maintaining Quality with Expanding Providers: Although 92% of commissioned providers are rated ‘good’ or ‘outstanding’, Our current large provider base requires significant contract management and quality assurance activity, to monitor performance and maintain acceptable standards of care. 
  • Geographical Staffing Disparities: Despite a strong presence of providers in Sutton and bordering authorities, recruiting and retaining sufficient staff across all 13 geographical patches remains difficult, particularly in areas with lower service utilization.
  • Addressing Service Utilization Imbalances: Significant variations in care hours across wards and gender disparities (63.2% female vs. 36.2% male) highlight a need for targeted outreach and service adjustments to ensure equitable access.
  • Evolving and Complex Care Needs: While the framework now includes learning disability and mental health support, the continued high proportion of physical support needs (66.6%) alongside rising demand for other complex needs requires ongoing adaptation and specialization within the provider network.
  • Efficiently Managing Increased Demand: The ability to onboard new providers through the Flexible Framework is beneficial, but efficiently managing their quality and integration to meet rising demand without compromising standards is crucial.

Market Influencers:

  • Demographic Shifts: An aging population, evidenced by 32.2% of care hours delivered to the 85-95 age group, is a primary driver of increasing demand and will continue to shape market priorities and resource allocation.
  • Regulatory Standards (CQC): The high percentage of ‘good’ and ‘outstanding’ CQC ratings (92%) reflects a responsive market, and continued focus on these standards will influence provider performance and innovation.
  • Local Provider Presence: The strong presence of providers registered in Sutton (21) and bordering local authorities (17) promotes local accountability and accessibility, influencing recruitment and service delivery models.
  • Policy Changes: National and local policy shifts related to integrated care, personalized budgets, and preventative health will continue to shape commissioning priorities and the evolution of home care services.
  • Technological Advancements: The Council’s commitment to leveraging technology for independent living will increasingly impact service offerings and provider operational models, encouraging innovation in assistive technology and remote monitoring.
  • Workforce Support: The commitment to increasing hourly rates and supporting the London Living Wage is a significant factor in attracting and retaining a skilled workforce, which is essential for service delivery.

Need and Demand

The June 2025 snapshot shows that demand for Sutton Council commissioned home care services decreased compared to the previous year. In June 2025, packages of care were delivered to 901 service users , compared to 955 in 2021/22.

How we need the market to develop for the future

Sutton Council is committed to fostering a home care market that is both responsive and sustainable. Our strategic development for 2026 will build upon the foundations of the Flexible Framework, with a continued emphasis on quality, efficiency, and empowering individuals. We will focus on:

  • Optimising Localised Provision: We will continue to support our lead home care providers within their geographical patches to ensure efficient travel times and strengthened community connections, thereby improving service reliability and continuity of care for residents.
  • Driving Outcome-Focused Care: Our commissioning approach will further develop approaches to support providers to deliver flexible and adaptable services that demonstrably achieve positive independence outcomes for individuals, moving beyond traditional hourly care.
  • Expanding Enabling Care Approaches: We will champion an enabling care model that extends beyond conventional home services, integrating rehabilitation, reablement, and proactive health promotion to support long-term independence.
  • Enhancing Business Operations and Person-Centred Service: We expect providers to implement revised business operations that include extended hours and robust staffing cover, ensuring a truly person-centred service that meets evolving resident needs.
  • Integrating Technology and Innovation: We will actively promote and increase the understanding and adoption of tech-enabled care to further enhance independence capabilities for residents.
  • Implementing the Trusted Assessor Role: The introduction of a new Trusted Assessor role within the provider workforce will streamline support coordination, facilitate timely equipment prescription, and effectively connect residents to local community resources, minimizing delays and enhancing overall care.

These developments are designed to continuously strengthen individual and community resilience, enabling residents to maintain their independence and live safely and fulfilling lives within their homes.